Barrett's Esophagus

Barrett's Esophagus

Barrett's Esophagus is a condition where the esophagus tries to repair itself from inflammation or ulceration due to the washback of acids.

What is Barrett's esophagus?

The muscular layers of the esophagus —the hollow tube that carries food and liquids from the mouth to the stomach— are normally pinched together at both the upper and lower ends by muscles called sphincters. When a person swallows, the sphincters relax to allow food or drink to pass from the mouth into the stomach. The muscles then close rapidly to prevent the food or drink from leaking out of the stomach back into the esophagus and mouth.

In some people, washback of acids will cause irritations or ulcerations of the esophagus. As a result, the esophagus tries to repair itself from inflammation or ulceration by repairing the original cell lining. In 12% of patients, this replacement lining will not be the original type found in the esophagus, but more like that of the stomach.
The formation of a new lining similar to the stomach is known as Barrett's esophagus. Estimated to affect 1.6 to 6.8 percent of people, men develop Barrett’s esophagus twice as often as women, and Caucasian men are affected more frequently than men of other races. Barrett’s esophagus is uncommon in children.

Follow-up treatment

Also, people with Barrett's esophagus are at increased risk for a rare type of cancer called esophageal adenocarcinoma.

What are the symptoms of Barrett's esophagus?

What causes Barrett's esophagus?

Gastroesophageal reflux disease (GERD) is known to most people as heartburn. GERD occurs when acid in your stomach flows up into your esophagus. It is common to develop heartburn at some point in one's life. Usually, modifying diet, avoiding foods high in fat, and minor lifestyle changes correct this condition.

In some patients, heartburn does not go away, and over time the acids in the stomach damage the cells in the esophagus to the extent that they cannot repair themselves ... and this can lead to Barrett's esophagus. Between 5–10 percent of people with GERD end up developing this condition.

What are the risk factors of Barrett's esophagus?

Obesity (especially in men who store large amounts of belly fat)• Smoking• Consuming rich foods high in fat (which forces the stomach to produce lots of acid to break down the food)• Possible genetic predisposition

Treatment for Barrett's esophagus

A health care provider will discuss treatment options for Barrett's esophagus based on the person's overall health, whether dysplasia is present, and, if so, the severity of the dysplasia. Treatment options include

People with Barrett's esophagus who have GERD are typically treated with acid-suppressing medications called proton pump inhibitors. These medications are used to prevent further damage to the esophagus and, in some cases, heal existing damage.

For people with GERD symptoms who do not respond to medications, anti-reflux surgery may be considered. However, medications and/or surgery for GERD and Barrett's esophagus have not been shown to lower a person's risk of dysplasia or esophageal adenocarcinoma.

Diet and Nutrition

People can make dietary changes to lower their risk of Barrett's esophagus. A high intake of fruits, vegetables, and vitamins may help prevent the disease. In addition, for people who are overweight, losing weight may reduce their risk. People should talk with their health care provider about dietary changes that can help prevent Barrett's esophagus.

Endoscopic Ablative Therapies

Endoscopic ablative therapies use different techniques to destroy the dysplastic cells in the esophagus. The body should then begin making normal esophageal cells. These procedures are performed by a radiologist, a doctor who specializes in medical imaging. Local anesthesia and a sedative are used. The procedures most often used are photodynamic therapy and radiofrequency ablation.

Photodynamic Therapy

Photodynamic therapy uses a light-activated chemical called porfimer, an endoscope, and a laser to kill precancerous cells in the esophagus. When porfimer is exposed to laser light, it produces a form of oxygen that kills nearby cells. Porfimer is injected into a vein, and the person returns 24 to 72 hours later to complete the procedure. The laser light passes through the endoscope and activates the porfimer to destroy Barrett's tissue in the esophagus.